WWYD - Dr. related for my 3 year old.

[justhat]

This has nothing to do with the issues you posted, BUT, my daughter had a UTI when she was 3yo and our ped said she sends all girls under age 6 (and boys of any age) who get a UTI for follow-up testing because sometimes they are the result of an underlying issue, Vesicouretal Reflux. So we took my daughter to the children's hospital for an ultrasound of her kidneys and a VCUG (voiding cystourethrogram). The 2nd isn't the most pleasant procedure, but thank gosh we had it done cause sure enough, my daughter has kidney reflux (or the term I mentioned above).

The reason this is so important to diagnose is that repeated infections can cause scarring on the kidneys (which is what the ultrasound is for) so you may need to put her on prophylactic antibiotics or take her in for urine cultures anytime she has an unexplained fever. Not every UTI in kids presents with pain while urinating. Some are just a fever with no other symptoms, so it's important to get a culture done if your child has kidney reflux.

I know it sounds extreme, but my daughter was 3.5yo and had ONE UTI, that's it. Never a problem before then so neither we nor her ped thought the test would actually show anything was wrong, but lo and behold it did.

Anyway, thought I'd throw this out there since I never thought this was a possibility and my husband is a physician so he's seen kids with it, but we never thought about it relating to our kid. We did a course of prophylactic antibiotics for about a year and the hope is that now, at age 6, that she has outgrown it.

 

[Scornelius]

Think about how much money you might lose because of this complaint.

Would you pay that amount to turn back time and have you daughter diagnosed properly? If so, you know what to do. If not.....

 

[agnes!]

So your annual bonus is more important than decent patient care? Good to know.

...It is sad to see that your yearly bonus means more to you then a bad doctor. It would tear me up to know that another child could go through this because I kept my mouth shut over money. ...

Now, before the posse gathers together, here is what the OP actually said...

...This is a very large healthcare facility, VERY LARGE that I also happen to work for. I have always been very happy with our benefits but it is SO hard for me to defend this company as as an employee when I have experiences like this as a member.

What would you do? I want to file a complaint but this complaint directly effects my annual bonus. This is just not right, she should have gotten antibiotics over 30 hours ago and she could already be feeling better by now.

The OP didn't say she wasn't willing to complain, all she actually said was "What would you do?" and that the possible complaint could/would directly affect her bonus. In today's financial climate, as much as people might like to think differently, job status and financial considerations can and do affect customers' health-care decisions.

agnes!

 

[Heidict]

Now, before the posse gathers together, here is what the OP actually said...



The OP didn't say she wasn't willing to complain, all she actually said was "What would you do?" and that the possible complaint could/would directly affect her bonus. In today's financial climate, as much as people might like to think differently, job status and financial considerations can and do affect customers' health-care decisions.

agnes!

Yeah, I did read what she said. IMO, by bringing up the correlation to her complaint and a bonus leads me to the conclusion that she is debating as to whether or not she will complain and is worried about losing money. Maybe I'm reading it wrong, but that thought would not even cross my mind if my child was in pain and the doctor was ignoring the obvious.

 

[mommy2allyandaveri]

So your annual bonus is more important than decent patient care? Good to know.

Clearly you can not read because that is NOT at all what I said. A few hundred dollars is not more important to my childs health.

I came on this board because I thought I could receive advice about a bad situation and instead I get flamed. Nice.

I did file a complaint this morning.

It's a complete conflict of interest that my bonus is tied to patient care results when I am in fact an employee and a patient. It's not just my bonus that is effected, it's thousands of other employees as well.

Thanks to those who actually offered advice instead of insulting me. I appreciate it.

 

[disfan07]

I dont think the wait is a big deal.

On average I wait about 30-40 minutes past my appt with the cardiologist and usually about 30 minutes past my appt time with my internist.

With my cardiologist its just because she has no sense of time what so ever but shes awesome so it doesnt bother me.

With my internist, she is so busy b/c she only works at her office 2 days a week so she has a constant stream of patients and sometimes she gets interuptions from the ER, other doctors etc. so its understandable.

Once you've waited 5 hours in the ER when having an asthma attack, waiting past an appt time at the doctors is no big deal

Now being misdiagnosed....I've been misdiagnosed more than once pertaining to everything from a simple sinus infection to pneumonia.
I'm very surprised that your doctor diagnosed her without seeing her just because of her age.

My internist will prescribe me antibiotics and prednisone over the phone and my pulmonologist will prescribe me prednisone over the phone because they are an hour drive from me and 95% of the time my problem is sinus infection and asthma flare up and i know exactly what the symptoms are and what they feel like. If I dont think it is a sinus infection or asthma, I would never wnat to get a diagnosis over the phone even if I had been seen by another doctor before...JMO

 

[gottaluvPluto]

Saturday afternoon dd3 starting crying while urinating, she said it burned on the inside. I immediately gave her cranberry juice and called the Dr. To my surprise they were able to make me an appt for Sun at 10am - great!

Sunday morning, arrive at the Dr. at 9:50am. They were swamped, clearly made too many appts. Around 10:30am a parent went up to ask about all these people and if they had appts, the receptionist said they all had appts but were being called back by order of arrival. At 11:15am I notice the person who check in right after me was called back, then we were called back. I told the MA who called me that the lady called before me had arrived after me and I would like to be seen before her (call me petty if you wish). 11:45am I am standing outside our room and I see the lady who had checked in after me leaving, they had been seen and were done before we were even seen! Ok, that is outrage #1.

Dr. comes in, not our normal pediatrician and says that although there is blood in her urine and white blood cells, it's not a UTI. I explain that dd has the following syptoms:

low grade fever
blood in urine
frequent urination
literally screaming while urinating
says it burns on the inside (her words as a 3 yr old, not mind)

She looks at DD's privates and says, there is some slight irritation and maybe some yeast going on. She assured me - no UTI and if it continued or worsened I should call in a few days.

We had a VERY rough night. Within an hour of getting up this morning she had gone to the bathroom 4 times and was screaming the entire time. She is terrified to go to the bathroom. I e-mailed her normal pediatrician this morning with how concerned I was. She just called about 45 minutes ago - IT'S A FREAKIN UTI!!!!!!!!!!!!!!!!!!!!! Exactly what I said it was. I am furious.

This is a very large healthcare facility, VERY LARGE that I also happen to work for. I have always been very happy with our benefits but it is SO hard for me to defend this company as as an employee when I have experiences like this as a member.

What would you do? I want to file a complaint but this complaint directly effects my annual bonus. This is just not right, she should have gotten antibiotics over 30 hours ago and she could already be feeling better by now.

My DD had a UTI at the age of three and it was not fun. When she would go to the bathroom I found that squirting warm water on the privates as she goes really helps with the burning. Also, if she gets another UTI when she is under 5 it could mean that she has some other medical problems. I'm not trying to scare you ... I'm trying to inform you because I wish someone informed me with my DD. My DD ended up having a kidney/bladder reflux and it was diagnosed late (bad doctor) and now she has some scars on her kidney. Anyway, just beware if she gets another UTI go and see a specialist. I hope I communicated this well for you ..... I'm not great at writing this out, I'm more of a talker. If you have any question just let me know. Good Luck!

 

[mommy2allyandaveri]

My DD had a UTI at the age of three and it was not fun. When she would go to the bathroom I found that squirting warm water on the privates as she goes really helps with the burning. Also, if she gets another UTI when she is under 5 it could mean that she has some other medical problems. I'm not trying to scare you ... I'm trying to inform you because I wish someone informed me with my DD. My DD ended up having a kidney/bladder reflux and it was diagnosed late (bad doctor) and now she has some scars on her kidney. Anyway, just beware if she gets another UTI go and see a specialist. I hope I communicated this well for you ..... I'm not great at writing this out, I'm more of a talker. If you have any question just let me know. Good Luck!

Thank you, that is really helpful information. When I thought she had a UTI from the beginning I was really shocked. I didn't have one until I was 19 or something. When I originally called the advice nurse suggested having her pee in the bathtub with warm water to help. I tried to get her to do this but she refused so no luck there. It goes against everything I've taught her, no wonder she is confused!

Her normal ped who called last night and diagnosed with a UTI did so based on the culture they did which takes 24 hours to grow.

The original provider looked at the urine but apparently thought that even though there was blood and white blood cells it was not a UTI.

My feeling is that based on all of her symptoms it was looking like a UTI, she did not explain that in 24 hours once a culture grows things change. She sent us on our way and said DD would be fine and if not to just call back in a few days. This was not ok.

 

[Anne34]

This has nothing to do with the issues you posted, BUT, my daughter had a UTI when she was 3yo and our ped said she sends all girls under age 6 (and boys of any age) who get a UTI for follow-up testing because sometimes they are the result of an underlying issue, Vesicouretal Reflux. So we took my daughter to the children's hospital for an ultrasound of her kidneys and a VCUG (voiding cystourethrogram). The 2nd isn't the most pleasant procedure, but thank gosh we had it done cause sure enough, my daughter has kidney reflux (or the term I mentioned above).

The reason this is so important to diagnose is that repeated infections can cause scarring on the kidneys (which is what the ultrasound is for) so you may need to put her on prophylactic antibiotics or take her in for urine cultures anytime she has an unexplained fever. Not every UTI in kids presents with pain while urinating. Some are just a fever with no other symptoms, so it's important to get a culture done if your child has kidney reflux.

I know it sounds extreme, but my daughter was 3.5yo and had ONE UTI, that's it. Never a problem before then so neither we nor her ped thought the test would actually show anything was wrong, but lo and behold it did.

Anyway, thought I'd throw this out there since I never thought this was a possibility and my husband is a physician so he's seen kids with it, but we never thought about it relating to our kid. We did a course of prophylactic antibiotics for about a year and the hope is that now, at age 6, that she has outgrown it.

My daughter has the same thing. She had a couple UTI's as a child (they gave her antibiotics right away -- one time it was very evident on the test, the other so/so, but she had lots of pain and elevated white count so they gave us the meds.) Our doctor didn't send us for the test until she had her 3rd UTI at age 8 -- they said kids should not get uti's. She was having one every 18 months or so -- not horrible, but something to look into.

She is now 12 and we go to the children's hospital here in Chicago yearly for renal ultrasound and VCUG. She took small daily dose of antibiotics for awhile and they it went to a dose every 3 days. She hasn't taken any meds in 2 years. They problem hasn't totally corrected itself yet. They said wait until she is out of puberty -- if it hasn't gone away, they might do surgury to repair the valve.

 

[mommy2allyandaveri]

Yikes, that is scary! Do they know what was causing the UTI's in the first place? If it occurs again I will definately talk to our ped about further testing.

I really do like our ped and have had nothing but wonderful experiences with her.

 

[shortbun]

Outrage #1 would be a non issue as the misdiagnosis is much more important. IF you plan to complain, make sure you choose the really important stuff to complain about or they will ignore your complete complaint if they find you petty. AND, perhaps they triagged patients and put the other patient ahead of you for a good reason that is not your business.

Did your regular ped diagnose and prescribe over the phone? See, that would worry me. AND, if it's yeast-the antibiotic will make it worse. Get out the acidopholus right away, it will help with the yeast and with any other side effects of the antibiotic.

 

[Heidict]

Yikes, that is scary! Do they know what was causing the UTI's in the first place? If it occurs again I will definately talk to our ped about further testing.

I really do like our ped and have had nothing but wonderful experiences with her.

Stay with your pedi, it's hard to find one that you like and are comfortable with. In the future though, when making last minute or sick appointments, just tell them that you don't want your daughter scheduled with that other doctor. Ugh, I would just want to go down there and throttle them after what she said.

Does you daughter do bubble baths? They say that this can lead to UTI's. I suffered through quite a bit of UTI's years ago and the pain is enough to make you want to pound your head against the wall and because of this I won't let my daughter have bubble baths because I know that it can cause them. It would break my heart to see her go through the pain. Glad your DD is doing better.

Outrage #1 would be a non issue as the misdiagnosis is much more important. IF you plan to complain, make sure you choose the really important stuff to complain about or they will ignore your complete complaint if they find you petty. AND, perhaps they triagged patients and put the other patient ahead of you for a good reason that is not your business.

Did your regular ped diagnose and prescribe over the phone? See, that would worry me. AND, if it's yeast-the antibiotic will make it worse. Get out the acidopholus right away, it will help with the yeast and with any other side effects of the antibiotic.

Her regular pedi diagnosed over the phone only because the lab results came back showing that it was a UTI.

 

[laurie31]

Poor little thing! I hope she feels better soon! A UTI is so miserable!

I'm going to have to be the lone supporter of your wait vent. I would understand the wait on a weekend, but I would NOT be happy about someone being called back before me who registered after me (and I presume whose appointment time was later). Now if it was the ER and not a peds office, I would presume the person had a sicker child than I did, but in the office I would at least have at least brought it to their attention.

Next I will second, or rather third, the "get her checked out for vesicoureteral reflux" people. It's not something you want to let go for too long. I also had this problem, and ended up having the surgery to repair it. By that time, I had so much scar tissue, that I effectively have only one functional kidney. My doctor now keeps a close eye on my renal functions just in case.

 

[mommy2allyandaveri]

Thank you so much everyone for the helpful info. Tonight I plan to do more research on vesicoureteral reflux and will e-mail her provider.

People keep asking me about bubble baths and her "wiping" habits. She takes baths but they are very short, in and out. She is probably sitting in water for less than 3-5 minutes. And she actually wipes correctly, something I still can't seem to get my 6 year old to do. She's 3 so I'm sure she doesn't do it perfectly everytime but she does pretty well. We've had many more "irritation" issues with the 6 year old. She's never had a UTI.

 

[ADAMS4]

Poor kid. I would also recommend asking about Ves. reflux. My dd was diagnosed with it on both sides at the age of 3. She never had a UTI, and out of nowhere had a full blown kidney infection. We did the antibiotics for 3 years, and thankfully didn't have any breakthrough infections. She never outgrew it, and had to have it surgically reapired. She has some scarring and one of her kidneys is smaller. Hopefully your dd doesn't have it, and it's her last UTI...they are so painful.

 

[Stacy9402]

I thought I would post on her with my DD's experience. She was getting UTI's pretty often. So they sent her for the tests. She was fine with ultrasound but the VCU was very uncomfortable for her but they both came back normal. We eventually found out that the toliet paper was irritating her. So we switched to the wet wipes for the bathroom and then eventually went back to TP but switched brands because Charmin had too much lint for her. So she uses just a generic brand that isnt soft so she doesnt get the lint.

 

[OceanAnnie]

Think about how much money you might lose because of this complaint.

Would you pay that amount to turn back time and have you daughter diagnosed properly? If so, you know what to do. If not.....

The way I see it, the OP would get a double whammy. Poor care for her child and no bonus. Two strikes. She can't turn back the hands of the clock. It happened.

OP, I would speak to your regular Pediatrician about it. I'd let him know how you felt and the dilemma you are facing. Maybe he can handle it without you being penalized for it.

 

[INDISMOM]

This has nothing to do with the issues you posted, BUT, my daughter had a UTI when she was 3yo and our ped said she sends all girls under age 6 (and boys of any age) who get a UTI for follow-up testing because sometimes they are the result of an underlying issue, Vesicouretal Reflux. So we took my daughter to the children's hospital for an ultrasound of her kidneys and a VCUG (voiding cystourethrogram). The 2nd isn't the most pleasant procedure, but thank gosh we had it done cause sure enough, my daughter has kidney reflux (or the term I mentioned above).

The reason this is so important to diagnose is that repeated infections can cause scarring on the kidneys (which is what the ultrasound is for) so you may need to put her on prophylactic antibiotics or take her in for urine cultures anytime she has an unexplained fever. Not every UTI in kids presents with pain while urinating. Some are just a fever with no other symptoms, so it's important to get a culture done if your child has kidney reflux.

I know it sounds extreme, but my daughter was 3.5yo and had ONE UTI, that's it. Never a problem before then so neither we nor her ped thought the test would actually show anything was wrong, but lo and behold it did.

Anyway, thought I'd throw this out there since I never thought this was a possibility and my husband is a physician so he's seen kids with it, but we never thought about it relating to our kid. We did a course of prophylactic antibiotics for about a year and the hope is that now, at age 6, that she has outgrown it.

This is almost exactly what I went through with my youngest daughter, only she was 2 months old when she got her first UTI. Let me tell you a 2 month old screaming bloody murder with a 104 temp is a scary thing!

Luckily my daughter also outgrew her reflux after about 2 years. However, she still gets UTI's. This is due to a "hook" in her urethra where urine can collect. We know all of her symptoms and usually when we take her in they can't find an infection, but find blood cells in her urine. If we aren't seeing our normal pediatrician, we explain that she is prone to them and they usually give us a scrip -- however some of them still make us wait for the culture to come back. Kind of frustrating, but we usually catch it before it starts to hurt, so we aren't that upset to wait.

 

[ols386]

The problem with diagnosing a UTI is that the doctors want the culture back in order to give the correct antibiotic.

My dd recently had an UTI, although she had no pain with it and we did not even know she had it.

They can give the pills that make your urine red to relieve pain. I think they sell something in the store OTC, to that effect.

So it is not uncommon to wait on an antibiotic for a UTI, OP. Just want to FYI you.

I've had those pills that you are referring, but I thought they were only available with a prescription. But anyway, it does turn the urine kind a reddish-orange, almost like kool-aid, and it definitely relieves the pain, I think actually, it numbs the bladder so that you can't feel the pain.




OP - As for the diagnosis, personally, I doubt it would make any difference to complain about it. As some previous posters have noted, they can't always tell from the urine if it's a uti, but wait for the culture to give antibiotics.

I am sorry that you and your daughter had to experience this.

 

[Ciciwoowoo]

I think it is more important for you as an employee to make a complaint. Your opinion is likely to be weighed more heavily. But even if it is not, other customers will voice their opinions through they wallets. They won't come back!!! If this problem is addressed, your bonus will have a better chance of remaining intact.

I do know that doctors are very hesitant to give antibiotics anymore due to abuse of them in years past. I know it is horrible to watch your little one go through the pain, but by not using them, when your little one needs them, they really will be more effective.